@article{ref1,
title="Socioeconomic and geographical disparities in prescription and illicit opioid related overdose deaths in Orange County, California from 2010-2014",
journal="Substance abuse",
year="2019",
author="Marshall, John R. and Gassner, Stephen F. and Anderson, Craig Lewis and Cooper, Richelle J. and Lotfipour, Shahram and Chakravarthy, Bharath",
volume="40",
number="1",
pages="80-86",
abstract="Background Reports indicate a geographic effect of socioeconomic inequalities on the occurrence of opioid-related fatal overdoses. We aim to (1) estimate the rates of opioid-related overdoses, (2) estimate the association of benzodiazepine co-ingestion with opioid-related deaths, (3) estimate associations between socioeconomic indicators and opioid-related deaths, and (4) map the distribution of fatal overdoses, in Orange County (OC), California. <br><br>METHODS We conducted an ecologic study of all opioid related deaths (1205 total) obtained from the OC Coroner Division database from 2010-2014 (1065 OC residents, 55 non-residents, 85 OC homeless) (analyzed 2016-2017). We calculated rates of opioid overdose, benzodiazepine co-ingestion prevalence and associations with SES (education, poverty, median income) using zip code analysis in the residential and homeless communities. <br><br>RESULTS Of 1205 deaths, 904 involved prescription type opioids, 223 involved heroin, 39 involved both, and 39 not stated. 973 were classified unintentional overdoses, 180 suicides, and 52 undetermined. 49% of cases involved benzodiazepines. Prescription type opioid and heroin death rates for residents were 5.4/100,000 person years (95% CI 5.0-5.8) and 1.2/100,000 person years respectively (95% CI 1.0-1.4). Males, age group 45-54 and Caucasian race had the highest rate (13.6/100,000) of opioid mortality. The highest death rates were seen in homeless adults at 136/100,000 person years for prescription type opioids (95% CI 99.0-185.5) and 156/100,000 person years for heroin (95% CI 116.8-209.5). <br><br>CONCLUSIONS The burden of prescription type opioid-related death in OC affects all demographics and levels of SES, there is a disproportionately high rate of opioid-related deaths in the OC homeless population.<p /> <p>Language: en</p>",
language="en",
issn="0889-7077",
doi="10.1080/08897077.2018.1442899",
url="http://dx.doi.org/10.1080/08897077.2018.1442899"
}